Changes in white matter integrity follow excitatory rTMS treatment of post-stroke aphasia.
Changes in white matter integrity follow excitatory rTMS treatment of post-stroke aphasia.
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DOI：
10.3233/rnn-2011-0627
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发表时间：
2012
影响因子：
2.8
通讯作者：
Szaflarski JP
中科院分区：
文献类型：
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作者：
Allendorfer JB;Storrs JM;Szaflarski JP
在这项研究中，我们研究是否兴奋性重复经颅磁刺激（rTMS）协议称为间歇性θ脉冲串刺激（iTBS）适用于受影响的左半球导致白色物质分数各向异性（FA）的变化。在8名失语性卒中患者中收集了10次每日iTBS治疗前后的扩散张量成像（DTI）数据。使用功能神经影像分析软件进行结构和DTI数据的比对，并推导扩散指数图，然后使用FMRIB软件库进行基于轨道的空间统计。进行配对t检验以比较rTMS前后FA的变化。在额下回、额上级和胼胝体前部附近，左半球FA显著增加（p<0.001）。右侧中脑和双侧颞叶、顶叶和后扣带回区的FA也增加。双侧梭状回附近和左侧小脑FA减少。总的来说，显示FA增加的左半球区域对应于先前显示iTBS后fMRI语言激活增加的区域。刺激部位附近增加的白色物质完整性可能反映了兴奋性rTMS通过其促进突触连接的能力介导的皮质功能的改善。
In this study, we examine whether an excitatory repetitive transcranial magnetic stimulation (rTMS) protocol called intermittent theta burst stimulation (iTBS) applied to the affected left hemisphere leads to changes in white matter fractional anisotropy (FA). Diffusion tensor imaging (DTI) data were collected in 8 aphasic stroke patients before and after 10 daily iTBS treatments. Alignment of structural and DTI data and derivation of diffusion index maps were performed using Analysis of Functional NeuroImages software followed by Tract-Based Spatial Statistics using FMRIB Software Library. Paired t-tests were performed to compare pre- to post-rTMS changes in FA. There were significant (p<0.001) left-hemispheric FA increases near the inferior and superior frontal gyri and anterior corpus callosum. FA also increased in the right midbrain and bilaterally near temporal, parietal and posterior cingulate regions. FA decreased bilaterally near the fusiform gyrus and in left cerebellum. Overall, left-hemispheric regions that showed increased FA corresponded to areas previously shown to have increases in fMRI language activation after iTBS. The increased white matter integrity near the stimulation sites may reflect improvements in cortical function mediated by excitatory rTMS through its ability to facilitate synaptic connections.